Abstract:

Aim: was to study in-hospital results of high-risk percutaneous coronary intervention (PCI) with extracorporeal circulatory support.

Material and methods: a single center, retrospective study was performed in 49 adult patients undergoing high-risk PCI with mechanical circulatory support (cardiopulmonary bypass - CPB and еxtracorporeal membrane oxygenation – ECMO) performed in high-risk patients with acute coronary syndrome, multiple coronary lesions and impaired ejection fraction between 2011 to 2019. Mean age was 64,4±6,7 years. Previous myocardial infarction had 38(77%) patients, 18(37%) patients had a history of previous cardiac surgery. In 18(37%) patients, ejection fraction (Simpson) was less than 30%. Mean value of the left main (LM) artery stenosis was 74,6±8,9%, while combined with occlusion or subocclusion right coronary artery (RCA) in 38(77%) patients. Multivessel coronary lesion had 42(86%) patients (average SYNTAX Score was 42,1±11,5 points)

Results: 17 patients (35%) underwent high-risk PCI under preventional mechanical circulatory support with CPB. Myocardial infarction, strokes, stent thrombosis, limb ischemia, lethal outcomes were not observed in these patients. 7(14%) patients were admitted to the Cath Lab with myocardial infarction complicated by cardiogenic shock, in 3 patients – with pulmonary edema. 12(24%) patients after previous heart surgery were admitted to the Cath Lab after cardiopulmonary resuscitation on extracorporeal circulatory support, four of them (8%) with ongoing chest compressions. In 6(12%) patients, during CAG/PCI, critical hemodynamic instability was observed, induced by incurable cardiac arrhythmias required an emergency extracorporeal support. Average time of extracorporeal circulatory support was 128,62±92,4 min. Complications associated with CPB and ECMO were not observed. Two patients (4%) had stroke in the postoperative period. Hospital mortality was 17(34,7%) patients.

Conclusion: extracorporeal circulatory supports provide good life maintenance for high-risk PCI and an possibility for emergency PCI in extreme clinical situations.

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Abstract:

Aim: was to estimate efficacy of methods of permanent or temporary blocking of blood flow through the gastroduodenal artery (GDA) during arterial chemoinfusion/chemoembolization of hepatic and pancreatic malignancies.

Materials and methods: for the period of 5 years (2015-2019), GDA embolization with coils was performed in 90 patients. Of them, 39 patients with liver tumors underwent occlusion of proximal GDA. GDA embolization distally to pancreatic branches (commonly on the level of gastroepiploic artery) was done in 51 patients with pancreatic head adenocarcinoma. Alternatively, in 12 patients with liver and 23 patients with pancreatic cancer, hand compression of GDA was used.

Results: technical success was 98% (88/90 patients). During embolization, coil migration into the hepatic artery developed in two patients with liver tumors: in one case stenting of the common hepatic artery was performed, the other case was asymptomatic and the presence of coil did not complicate the following arterial therapy. There were no other complications. Patients received multiple repeated courses of arterial chemotherapy.

Conclusion: methods of blocking of GDA blood flow are relatively safe, effective, simple and inexpensive. Both, embolization and hand compression, help to prevent non-target chemoinfusion and embolization.

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Abstract

The phenomenon of unrecovered coronary blood flow, or the «no-reflow» phenomenon, is the most formidable and insufficiently studied example of clinical failures after percutaneous coronary intervention (PCI) and is manifested as the absence of filling of distal coronary arteries. As a result, endovascular treatment may be completely unsuccessful or may be complicated by delayed recovery, the development of systolic dysfunction, the formation of heart aneurysm and other serious problems. Many experimental and clinical studies have been devoted to «no-reflow», but the evidence for this or that way of influencing the appearance of this phenomenon is very ambiguous. This article presents modern aspects related to risk factors, pathophysiology and methods for diagnosing this complication, as well as an analysis of methods for the prevention and correction of the developed «no-reflow» phenomenon.

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Abstract:

Infra-popliteal lesions rarely were the zone of interest in first years of endovascular era. Nowadays, broad worldwide experience of transluminal interventions and appearance of low-profile instruments allowed broadening of the indications for transluminal repair of the below-the-knee arteries. The method is proved to be safe and effective.

Results of 121 angioplasties in 70 patients with chronic ischemia of the legs (12 years work of a city hospital) are analyzed in the article. The main indication was stenotic and occlusive infrapopliteal lesions excluding the possibilities of bypass surgery. It was shown that the endovascular approach is extremely effective, and in cases of diabetic angiopathy and critical lower extremities ischemia, an endovascular intervention can be not only the way to save a leg, but the only way to save the patient's life.

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Abstract:

From January 2003 till January 2008 transhepatic endobiliar stenting was performed in 62 patients with obstructive jaundice due to high post-operative malignant strictures of hepaticocholedochus duct. In 49 cases (79 %) two-step intervention performed (biliary drainage followed by endobiliary stenting), 13 patients (21 %) underwent single-stage intervention. In 60 patients (96,8%) balloon dilatation was done prior to stent implantation. In 59 cases (95,2%) the procedure was completed by control drainage placement. Hospital stay for the endobiliary stenting procedure was 12,7-22,3 days (average hospital stay 17,5 days). Mortality was as high as 12,9% (8 cases). Average post-implantation life span appeared to be 9,7 months. In 5 patients (8,1%) mechanical jaundice relapse occurred, so they needed hospitalization for reintervention. Direct dependence found between the effectiveness of endobiliary stenting and the technical characteristics of stents, anatomy of biliary strictures, as well as the methods and techniques of the intervention. Single-stage endobiliary stenting, without prior drainage, decreases the complication rate, improves the quality of life during the hospital stay, and prolongs the post-implantation life expectancy. Single-stege interventions are also shown to decrease the hospital stay and reduce the costs. Balloon dilatation is the required stage of the intervention, especially if self-expandable stents are used in torturous biliary ducts. Post-implantation drainage placement can be skipped if the wall of the hepatico-choledochus duct is not edematous, there are no signs of tumor prolapse into the lumen, if the stent is completely expanded, and the contrast media evacuates easily into the intestine.

Reference

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Abstract:

122 cases of gastroesophageal bleeding due to portal hypertension are analyzed in the article. It is shown that transcatheter interventions, as a part of the complex hemostasis strategy, can significantly improve the results. Keeping to algorithms and acting in accordance with protocols developed for any diagnostic procedure or intervention are declared to be crucial to success. The complex approach to profuse bleeding management, that included transcatheter procedures, decreased mortality rate from 72,2% to 22,1% and reduced rebleeding rate from 47,2% to 31,4%. 

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Abstract:

The aim of the study was to evaluate results of percutaneous coronary interventions (PCI) in patients with ischemic cardiomyopathy (ICMP) - potential candidates for heart transplantation. The study included 37 patients with ICMP. All the patients before PCI and within the 7 days after it undergo ec-hocardiography and ECG-gated SPECT. The amount of irreversibly damaged myocardium of the left ventricle (LV) was about 50 % of its volume. In these patients ECG-gated SPECT did not show sufficient amount of the viable myocardium, capable to restore the heart function after revascularization. The main result of intervention was increase in survival rate of patients with ICMP within 4 years of observation in comparison with traditional methods of conservative therapy. The first clinical effect of PCI was disappearance or reduction of dyspnea, noted in the majority of the patients. These changes had been confirmed by improvement of a functional class of patients (NYHA class score increase to 3,2±0,5 from 1,7+65; p=0,007) and increase of tolerance to physical excersise. Positive changes of a clinical condition after PCI have taken place due to decrease in rigidity of LV myocardium: It became apparent due to decrease of LV end-diastolic pressure (35,7+9,3 vs. 23,5+9,9 Hg mm; p=0,04) and pressure in pulmonary artery (44+1 2 vs. 33+7 Hg mm; p=0,03). No changes of LV volumes and ejection fraction values in the given category of patients were seen.

Reference 

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Abstract:

Results of minimal invasive percutaneus drainage interventions under US-control in 45 children, aged 1-4 years with intraabdominal abscesses of different genesis are presented. Intraabdominal abscesses were identified as subdiaphragmatic (16), intrafilar (22) and pelvic (19). Difference between US-characteristics of intraabdominal abscesses, preoperative planning peculiarities and interventional technologies, that depend on localization of abscesses are presented.

The usage of 3D-echography results data in 13,3% of children increased the value of diagnostics: for optimization of surgical approach, kind and volume of intervention.

Percutaneus drainage intervention under ultrasound control is effective and non-traumatic method of treatment. 

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Abstract:

It has been described the experience of use of automatic injector Mark V Pro Vis (Medrad) for endovascular interventions in pediatry. The choice of optimal roentgen contrast media for angiography and endovascular interventions is considerated. It has been concluded that contrast enhancement by iopromide and automatic injector Mark V Pro Vis is effective and safety method of visualization of vessels, tumors and other pathology.  

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Abstract:

Purpose. To assess the effectiveness of palliative endovascular interventions in patients with CTO anatomy infavorable for recanalisation.

Material and methods. The authors analyzed the results of interventions in 60 patients (50 male (83,3%), 10 female (16,7%)) aged 38 – 75 years (mean age 53,9±3,2), with occlusive coronary disease. Palliative revascularizations were performed in 30 patients, and CTO recanalization was done in 30 cases. The LV function was assessed echocardiographically in both groups before and after the intervention.

Results. 12 month follow-up showed significant improvement or normalization of LV function in both groups. Results of palliative interventions were shown to be as effective as recanalization of CTO.

Conclusions. Endovascular palliation is effective in treatment of patients with coronary CTO. It results in myocardial function improvement comparable to that in patients with complete coronary revascularization.   

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6.        Иоселиани Д.Г., Громов Д.Г., Сухоруков О.Е., Хоткевич Е.Ю., Семитко С.П., Исаева И.В., Верне Ж.-Ш., Арабаджян И.С., Овесян З.Р., Алигишева З.А. Хирургическая и эндоваскулярная реваскуляризация миокарда у больных с многососудистым поражением венечного русла: сравнительный анализ ближайших и среднеотдаленных результатов. Международный журнал интервенционной кардиоангиологии. 2008; 15: 22–31.

7.        Араблинский А.В. Степень реваскуляризации миокарда с помощью транслюминальной баллонной ангиопластики у больных с многососудистым поражением коронарного русла. Международный медицинский журнал. 2000; 1: 2–6.

8.        Ott R.A., Tobis J.M., Mills T.C., Allen B.J., Dwyer M.L. ECMO assisted angioplasty for cardiomyopathy patients with unstable angina. Department of Cardiothoracic Surgery, University of California. Irvine Medical Center. 2006.  

9.        Gaudino M., Santarelli P., Bruno P., Piancone F.L., Possati G. Palliative coronary artery surgery in patients with severe noncardiac diseases. Department of Cardiac Surgery, Catholic University. Rome. Italy. 2006.  

10.      Гринхальх Т. Основы доказательной медицины. Учебное пособие. М. 2004; 58.  

11.      Петросян Ю.С., Иоселиани Д.Г. О суммарной оценке состояния коронарного русла у больных ишемической болезнью сердца. Кардиология. 1976; 12 (16): 41–46.

12.      Петросян Ю.С., Шахов Б.Е. Коронарное русло у больных с постинфарктной аневризмой левого желудочка сердца. Горький. 1983; 17–37.

13.      Rahimtoola S.H. The hibernating myocardium. Ibid. 1989; 117: 211–221.

Abstract:

Endovascular interventions became widespread for last decade. The directional atherectomy with a SilwerHawk device is one of such methods of possible vascular restoration. This method has some advantages than balloon angioplasty or stenting.

Aim: Was to evaluate the efficiency of directional atherectomy with a SilwerHawk device with iliac arteries disease and arteries of legs disease.

Materials and methods: We have included nine patients with peripheral arterial disease in our study the endovascular directional atherectomy with a SilwerHawk device (EV-3) was performed in all patients. We used different accesses to the artery and protocols of interventions. In all cases we used distal embolic protection device «Spider» (EV-3).

Results: The immediate results of intervention were evaluated. We developed operation algorithms in different cases of vessel disease. The article describes the technical aspects and nuances of work with SilwerHawk device. The perioperative tactics of treatment are also considered in it.

Conclusion: Endovascular atherectomy is a new and effective method in treatment of patients with different peripheral arteries disease. It provides allows considerably to expand the field of methodics application. 

References 

1.      Norgren L., Hiatt W., Dormandy J. et al. Inter Society Consensus for the Management of peripheral Arterial Disease (TASC II). J. Vasc. Surg. 2007; 1:1-75.

2.      Покровский А.В., Алекян Б.Г., Аралекян В.С. и соавт. Диагностика и лечение больных с заболеваниями периферических артерий. (Рекомендации Российского общества ангиологов и сосудистыххирургов) Москва 2007.

3.      King S., Smith S., Hirshfeld J. et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J. Am. Coll. Cardiol. 2008; 51(2): 172-209.

4.      Abstracts of CIRSE (Cardiovascular and Interventional Radiological Society of Europe) 2010.Cardiovasc Intervent Radiol. 2010; 33(2):14-313.

5.      John L. Limitations of Percutaneous Transluminal Angioplasty and Stenting for the Treatment of Disease of the Superficial Femoral and Popliteal Arteries. Journal of Endovascular Therapy. 2006; 13(2): 30-40.

6.      Thomas Z. Current state of endovascular treatment of femoro-popliteal artery disease. Vasc Med. 2007; 12: 223.

7.      Adam D., Beard D., Cleveland T. et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2006; 367(9525): 14.

8.      Schillinger M, Minar E. Past, present and future of femoropopliteal stenting. J Endova,sc Ther. 2009; 16(1): 52-147.

9.      Cotroneo A., Pascali D., Santoro M. et al. Endovascular treatment of femoropopliteal steno-obstructive disease with percutaneous transluminal angioplasty: midterm results. Radiol. Med. 2008; 113(7): 1043-55.

10.    Furuichi S., Sangiorgi G., Colombo A. Early Occlusive Restenosis Due to Self- Expandable Stent Squeeze in the Popliteal Artery. J. Invasive Cardiol. 2007; 19(10): E300-2.

11.    Laird J., Katzen B., Scheinert D. et Al. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelvemonth results from the RESIL

Abstract:

We have analyzed long-term results of different revascularization strategies in 171 patients with multivessel coronary artery defeat. Duration of follow up observation ranged from 12 to 18 months. Complete revascularization of the myocardium was performed in 63 pts, culprit vessel revascularization - in 86 and incomplete revascularization - in 22 patients. All patients undervwent SYNTAX scoring analysis to find out possible risks of transcutaneus coronary interventions. Survival rate, incidence of myocardial infarction, repeat myocardial revascularization procedures and major adverse cardiac events were comparable among the patients with low and intermediate SYNTAX Score. Among the patients with high SYNTAX Score the incidence of myocardial infarction (8,82%, р = 0,002), repeat PCI procedure (32,35%, р = 0,001) and major adverse cardiac events (32,35%, р = 0,002) was reliably higher compared to patients with low and intermediate SYNTAX Score. The mpact of the SYNTAX Score rate on the long-term results in the different revascularization strategy groups was also analyzed. In the 1st group the incidence of major adverse cardiac events among the patients was comparable. In the 2nd group patients with the high SYNTAX Score rate had reliably higher rate of major adverse cardiac events (43,75%, р = 0,002). The rate of major adverse cardiac events were higher in the 3rd group of patients with the high SYNTAX Score rate compared in patients with low and intermediate SYNTAX Score rate, but this difference didn't reach statistically reliable difference. Use of the strategy of culprit vessel revascularization in the patients with high SYNTAX Score rate, leads to increased rate of major adverse cardiac events and repeat PCI procedures in the long-term follow up period.

References 

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2.    Bourassa M.G. et al. Strategy of complete revascularization in patients with multivessel coronary artery disease (a report from the 1985-1986 NHLBI PTCA Registry).

3.    Am. J. Cardiol. 1992; 70: 174. Bourassa M.G. et al. Long-term outcome of 5 patients with incomplete vs complete revascularization after multivessel PTCA (a report from NHLBI PTCA Registry). Eur. Heart. J. 1998; 19: 103-111.

4.    Hannan E.L. et al. Impact of completeness of percutaneous coronary intervention revascularization on long-term outcomes in the stent era. Circulation. 2006; 113; 2406-2412.

5.    Hannan E.L. et al. Incomplete revascularization in the era of drug-eluting stents. Impact on adverse outcomes. J. Am. Coll. Cardiol. Intv. 2009; 2: 17-25.

6.    Ijsselmuiden A.J.J. et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease. A randomized comparison. Am. Heart. J.2004; 148: 467-474.

7.    Martuscelli E. et al. Revascularization strategy in patients with multivessel disease and a major vessel chronically occluded. Data from the CABRI trial. Eur. J. of Card.Thorac. Surg. 2008; 33: 4-8.

8.    Van den Brand M.J.B.M. et al. The effect of completeness of revascularization on event-free survival at one year in the arts trial. J. Am. Col. Cardiol. 2002; 39; 559-564.

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13.  Rodriguez A.E. et al. Revascularization strategies of coronary multiple vessel disease in drug eluting stent era. One year follow-up results of ERACI III trial. Eurointervention. 2006; 2: 53-60.

14.  Rodriguez A.E. et al. Late loss of early benefit from drug-eluting stents when compared with bare-metal stents and coronary artery bypass surgery. 3 years follow-up of the ERACI III registry. Eur. Heart. J. 2007; 28: 2118-2125.

15.  Serruys P.W. et al. The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent. Insights from the Arteкial Revascularization Therapies Study Fart II (ARTS II). Eur. Heart. J. 2007; 28 (4): 433-442.

16.  Serruys P.W. et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N. Engl. J. Med. 2009; 360: 961-972.

17.  Serruys P.W. Sirolimus-eluting stents for the treatment of patients with multivessel de novocoronary artery lesions. EuroInterv. Arterial, Revascularis. Therap. Study PartII. 2005; 2: 147-156.

18.  Serruys P.W. et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention. 2009; 5 (1): 50-56.

Abstract:

Purpose. To assess early and late results of iliac arteries balloon angioplasty and stenting in patients with chronic lower limb ischemia.

Material and methods. We analyzed the results of terminal aortic and iliac lesions endovascular treatment in 222 patients. All the patients presented symptoms of lower-limb chronic ischemia: 2nd «b» grade - 51,2%; 3rd grade - 27,1%; 4th grade - 21,7%. Two hundred and fifty eight procedure were performed, including 98 (38%) balloon angioplasty and 160 (62%) stenting. The lesions were Type A -26%, Type B - 45%, Type C - 23%, and Type D - 51% according to TASC II classification.

Results. Immediate angiographic success rate was 99,4%, complication rate -1,3% (4 of 314). Cumulative primary patency after balloon angioplasty in terms of 1, 3 and 5 years were correspondingly 97,9%, 82,0% and 64,2%. After stenting it was as high as 98,1%, 85,2% and 71,8%. Secondary patency after balloon angioplasty in terms of 1, 3 and 5 years was correspondingly 99,0%, 89,4% и 75,6%. For stenting it was 99,4%, 93,0% and 85,6% (Kaplan - Meier). Long-term clinical success rates in 1 year, 3 and 5 years were correspondingly 97,9%, 98,7% and 88,8% for angioplasty and 92,6%, 63,7% and 72,6% for stenting. Five-year limb preservation rate was 92,4% for angioplasty and 98,6% for stenting.

Conclusions. Endovascular interventions are proved to be safe and efficient for iliac arteries atherosclerotic lesions, and to have good long-term results. 

References 

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2.    Покровский А.В. и др. Российский консенсус. Рекомендуемые стандарты для оценки результатов лечения пациентов с хронической ишемией нижних конечностей. М.2001; 16.

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5.    Казанчян П.О., Попов В.А., Дебелый Ю.В. и  др.  Аорто-подвздошно-бедренные   реконструкции       методом       эверсионной эндартерэктомии.   Разумный   возврат   к прошлому. Ангиология и сосудистая хирургия. 1999; 5: 71-80.

6.    Гуч А.А., Верещагин С.В., Кондратюк В.А. Определение   показаний   к   первичному рентгеноэндоваскулярному протезированию артерий подвздошно-бедренного сегмента. Эхография. 2000; 1 (2): 155-158.

7.    Bosch J.L., Hunink M.G.M. Metaanalysis of the   results   of   percutaneus   transluminal angioplasty and stent placement for aortoiliac occlusive   disease.    Radiology.    1997;    204: 87-96.

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            11.  Затевахин И.И., Дроздов С.А., Хабазов Р.И. Допплеросфигмоманометрия в диагностике поражений глубокой артерии бедра. Клиническая хирургия. 1985; 7: 24-2

Abstract:

Purpose. To assess safety and efficiency of simultaneous RCA and major branches of LCA stenting in patients with myocardial infarction (MI).

Material and methods. Authors analyzed data of 237 patients. Coronary angiography (CAG) revealed triple vessel stenotic and/or occlusive disease. Pre-procedure systemic thrombolysis (streptokinase) used in 54 patients. Endovascular interventions (PTCA and stenting of the infarct related artery) performed in all the cases; in 24 patients, simultaneous complete anatomical coronary revascularization (CACR) attempted. In 30 cases, after PTCA of the infarct related artery (PTCA IRA) patients were transferred to other hospitals for bypass surgery as a second stage.

Results. Systemic thrombolysis efficiency was 40 %(22 patients) according to echocardiography and 26% (14 patients) by CAG. TIMI III flow restored in 100%, immediate clinical success rate was 97,5%. There were no procedural complications. Six patients died early after the PTCA for cerebral hemorrhage, acute LV failure, and LV rupture. Absence of myocardial ischemia in CACR subgroup was confirmed clinically and in treadmill test. Patients of PTCA IRA subgroup presented with angina of various functional class.

Conclusions. Endovascular interventions are highly efficient as a component of complex IM treatment. Primary CACR is proved to decrease symptoms of myocardial ischemia. 

References 

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2.    Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия-2007. Болезни и врожденные    аномалии системы кровообращения. М.: НЦССХ им. А.Н. Бакулева РАМН.  2007; 144.

3.    Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия-2007. Болезни и врожденные аномалии системы кровообращения. М.: НЦССХ им. А.Н. Бакулева РАМН. 2008; 161.        7.

4.    Carver A. et al. Longer-term follow-up of patients recruited to the REACT (Rescue Angioplasty Versus Conservative Treatment or Repeat Thrombolysis) trial. J. Am. Coll. Cardiol. 2009; 54:1 18-126.

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7.      Stone G.W. et  al. Paclitaxel-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents. The TAXUS V ISR Randomized Trial. JAMA. 2006; 295: 1253-1263.

8.    Holmes J.D.R. et al. Sirolimus-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents. The SISR Randomized Trial. JAMA. 2006; 295: 1264-1273.

9.    Serruys P.W. et al. Periprocedural quantitative coronary angiography after Palmaz-Schatz stent implantation predicts the restenosis rate at six months. J. Am. Coll. Cardiol. 1999; 34: 1067-1074.

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13.  Colombo A. et al. Sirolimus-Eluting Stents in bifurcation Lesions. Six-Month Angiographic Results According to the Implantation Technique. Presented at the American College of Cardiology 52nd Annual Scientific Session. 2003.

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15.    Vаn den Brand M. et al. J. Amer. Coll. Cardiol. 2002; 39: 559-564.

16.    Lemos P.A. et al. Circulation. 2004; 109: 190-195.

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18.    Sousa J.E. et al. Circulation. 2003; 107; 381-383.

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Abstract:

Authors present their first 3 cases of thoracoabdominal aneurysm hybrid repair. Endovascular procedure and open surgery were used either simultaneously, or as the steps of reconstruction.

References

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12.       FannJ.I. et al. Surgical management of aortic dissection during a 30"year   period. Circulation. 1995; 92 (2): 113-121.

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14.       Buth J. et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. Аstudy from the European сollaborators on stent-graft techniques for aortic aneurysm repair  (EUROSTAR)  registry. J.   Vasc.  Surg. 2007; 46 (6): 1103-1111.

15.       Svensson L.G. et al. Experience with 1509 patients undergoing thoracoabdominal aortic operations.J. Vasc. Surg. 1993; 17: 357-370.

16.       Safi H.J. et al.  Distal aortic perfusion and cerebrospinal fluid drainage for thoracoabdominal and descending thoracic aortic repair.        Ten years of organ protection. Ann. Vasc. Surg. 2003; 238: 372-380.

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Abstract:

Aim: was to combine results of surgical treatment of patients with primary reconstruction of arteries of lower limbs with patients who underwent reconstructive operations on early stented arteries.

Materials and methods: research included 93 patients with critical ischemia of lower limbs. All patients were devided into two groups with division to subgroups. Group 1a - 23 patients after stenting of iliac arteries. Group 1b - 23 patients with stenosis or occlusion of iliac arteries without previous operations. Group 2a - 22 patients with thrombosis or restenosis of arteries lower than inguinal ligament after previous endovascular treatment. Group 2b - 25 patients with primary atherosclerotic lesion of arteries of lower limbs lower than inguinal ligament .

Results: in early postoperative period and 6 months after reconstructive operation there were no difference in all groups and subgroups of treated patients. The level of complications in late post-operative period is lower in case of primary reconstruction of arteries lower than inguinal ligament in comparison with operations after endovascular interventions.  

References

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5.     Gruberg L., Hong M.K., Mintz G.S., Mehran R., Waksman R., Dangas G., Kent K.M., Pichard A.D., Satler L.F., Lansky A.J., Kornowski R., Stone G.W., Leon M.B. Optimally deployed stents in the treatment of restenotic versus de novo lesions. Am. J. Cardiol. 2000 Feb 1; 85(3):333.

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